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The role community plays in protecting against the drug overdose crisis

Summary and Analysis…

A fascinating study that shows a clear link between a community’s “social capital” and its rate of opioid overdoses. The study was able to quantify “social capital” for a community and compare that to mortality due to drug overdose.

This link is to the abstract (which is included below). Particularly striking is the conclusion: “This study finds large-sample evidence that social capital protects communities against drug overdose. This finding could help guide policymakers in identifying where overdose epidemics are likely to occur and how to ameliorate them.”

This study appears to contain an important finding for policymakers, regulators, law enforcement and communities to take into account when designing strategies to address the opioid crisis.

Excerpted from ScienceDirect

Background

Drug overdose deaths have risen precipitously over the last fifteen years. Substantial geographic variation, beyond a simple rural-urban dichotomy, exists in the concentration of overdose deaths, suggesting the existence of as-yet unidentified environmental variables that predict resilience (or vulnerability) to drug overdoses. Motivated by reports highlighting the role of community fragility in the opioid epidemic, we explore whether social capital attenuates overdose death rates.

Methods

We conducted an ecologic temporal trends study from 1999 to 2014 to investigate the association between mortality due to drug overdose and social capital. Data from multiple sources were compiled at the county-level to produce an analytic dataset comprising overdose mortality, social capital, and a host of potentially confounding variables indicated by the literature (N = 49,664 county-years). Multinomial logistic regression was used to estimate the likelihood that a county falls in low (<4 deaths per 100,000), moderate, or high (>16 deaths per 100,000) categories of annual overdose morality.

Results

We observed a strong and statistically significant inverse association between county-level social capital and age-adjusted mortality due to drug overdose (p < 0.01). Compared to the lowest quintile of social capital, counties at the highest quintile were 83% less likely to fall in the “high-overdose” category and 75% less likely to fall in the “moderate-overdose” category.

Conclusion

This study finds large-sample evidence that social capital protects communities against drug overdose. This finding could help guide policymakers in identifying where overdose epidemics are likely to occur and how to ameliorate them.

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